Provider Demographics
NPI:1053900894
Name:WOODS PSYCHOLOGICAL, NEUROPSYCHOLOGICAL SERVICES,P.C.
Entity type:Organization
Organization Name:WOODS PSYCHOLOGICAL, NEUROPSYCHOLOGICAL SERVICES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:970-688-0852
Mailing Address - Street 1:42 LAKE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4937
Mailing Address - Country:US
Mailing Address - Phone:970-688-0852
Mailing Address - Fax:
Practice Address - Street 1:42 LAKE ST STE 1
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4937
Practice Address - Country:US
Practice Address - Phone:970-688-0852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-15
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty